36C25920D0048-001.pdf

OFOC SOP Revision 08 Page 1 of 5 Original Date: 03/22/11 Revision 08 Date: 04/18/2018

DEPARTMENT OF VETERANS AFFAIRS

Justification and Approval (J&A) For

Other Than Full and Open Competition (>SAT)

Acquisition Plan Action ID: 36C259-20-AP-1478, Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center, for Community Nursing Home

Services

Tracking ID: 2020-03-03T05:23:30

1. Contracting Activity: Department of Veterans Affairs, Network Contracting Office

19 (NCO19), 6162 South Willow Drive, Greenwood Village, CO 80111. This action is funded by a 1358. Therefore, there is no associated 2237.

2. Nature and/or Description of the Action Being Processed: This procurement is for the establishment of a sole source Firm-Fixed Price Indefinite Delivery Contract (IDC) for community nursing home (CNH) services for the Montana VA Medical Center (VAMC) to Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center located in Lewistown, MT 59457. This will be a 5-year IDC (60 Months). The period of performance will be 01 April 2020 through 31 March 2025.

FAR13.5 Simplified Procedures for Certain Commercial Items: This procurement is for the establishment of an IDC utilizing procedures in accordance with FAR 13.5 Simplified Procedures for Certain Commercial Items and specifically FAR 13.501 Special Documentation Requirements, where acquisitions conducted under Simplified Acquisition Procedures are exempt from the requirements of FAR Part 6, but still require a justification using the format of FAR 6. 303-2. This acquisition does not fall within FAR Part 8 Required Sources of Supplies and Services, therefore the procedures associated with limited sources justification will not be utilized.

3. Description of Supplies/Services Required to Meet the Agency’s Needs: The CNH will provide all facilities and services to support short- and long-term care for Veterans. These services include rehabilitation, nursing, and clinical care in accordance with the performance work statement. The current contract VA259-15- G-0067 expires on 31 March 2020. Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center has met all requirements under VA policy/directive established by the Office of Geriatrics and Extended Care.

Additionally, they are certified under Centers for Medicare and Medicaid Services (CMS) and licensed by the State of Montana. This will be a 5-year IDC (60 Months).

The period of performance will be 01 April 2020 through 31 March 2025. The total estimated value of this contract is

4. Statutory Authority Permitting Other than Full and Open Competition: 41 USC

§3304(a)(1), as implemented by FAR 6.302-1 (a)(2).

OFOC SOP Revision 08 Page 2 of 5

(X) (1) Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements per FAR 6.302-1;

( ) (2) Unusual and Compelling Urgency per FAR 6.302-2;

( ) (3) Industrial Mobilization, Engineering, Developmental or Research Capability or Expert Services per FAR 6.302-3;

( ) (4) International Agreement per FAR 6.302-4 ( ) (5) Authorized or Required by Statute FAR 6.302-5;

( ) (6) National Security per FAR 6.302-6;

( ) (7) Public Interest per FAR 6.302-7;

FAR13.5 Simplified Procedures for Certain Commercial Items: The authority for applying the Simplified Procedures for Commercial Items of FAR 13.5 is 41 U.S.C.

1901 and is implemented by for restricting competition on this procurement via FAR 13.106-1(b)(2).

5. Demonstration that the Contractor’s Unique Qualifications or Nature of the

Acquisition Requires the Use of the Authority Cited Above (applicability of authority): Currently, there are 3 Veterans being treated and housed at the Empres at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center facility under an existing BOA. Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center facility meets VA standards for quality of care to provide care and treatment to Veterans. Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center facility has had a contract with the VA since 2015 and they have consistently provided quality care to our Veterans. The Veterans at this facility cannot be moved without causing a disruption in the continuity of care and undue stress to both the Veterans and their families. The relocating of Veterans is not in accordance with VA policy/directive established by the Office of Geriatrics and Extended Care. In accordance with FAR 6.302-1, this requirement for community nursing homes services will be sole sourced to the Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center facility. In addition, as stated in paragraph 6 below, no responses were received from any potential offerors regarding the sources sought notice issued for this procurement.

6. Description of Efforts Made to ensure that offers are solicited from as many potential sources as deemed practicable: Market research, in accordance with FAR Part 10, was conducted by sources sought notice of the proposed acquisition, advising industry of the pending acquisition and soliciting inquires from interested parties. No new CNH has expressed interest in doing business with the Government. A search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 1 community nursing home in in Lewistown, MT, 59457, where the current CNH is located. The VA Vendor Information Page (VetBiz) was used to determine if potential offerors exist who would be able to provide the services required.

However, the site failed to produce any results for in Lewistown, MT, 59457. The CNH program requires that any new CNH's that want to do business with the

OFOC SOP Revision 08 Page 3 of 5

Revision 08 Date: 04/18/2018

Government must pass a series of inspections. The CNH must pass a clinical inspection and a life safety inspection. The CNH Program Coordinators meet with the CNH to understand the services that are offered. Once the CNH passes these inspections, they can be considered for a contract. As part of the acquisition process, a CNH must provide a current state license, insurance and a copy of the state inspection. These documents are provided to the CNH Program coordinator for review and evaluation. The CNH Coordinator will either provide a recommendation to contract or state that the CNH did not receive a recommendation to contract. A redacted J&A will be posted on Contract Opportunities.

7. Determination by the Contracting Officer (CO) that the Anticipated Cost to the

Government will be Fair and Reasonable: The Medicaid rates are used as the basis for pricing the CNH contracts. The Medicaid rates are established by each state based on national average. The VA Geriatrics and Extended Care Office through the VHA PM and VA pulse publishes an annual maximum allowable percentage that are applied to each RUGS IV category. The RUGS IV category identify the different levels of treatment. The add-on percentages are added to the basic Medicaid rate then applied to each RUGS IV category. The Medicaid rate and the VA add-on percentage make up the per diem rate paid for each Veteran. The line item structure will illustrate the different RUGS IV category and the add-on percentage and the total per diem rate for each level of care. After conducting research on the current Medicaid and RUGS IV rates, the CO has determined that the results are determined to be fair and reasonable when the add-on percentage agreed upon by both parties is at or under the maximum allowable percentage established by VA. The add-on percentages do not change through the life of the contract.

8. Description of the Market Research Conducted and the Results, or a Statement of the Reasons Market Research Was Not Conducted: As described in Section 6 above, a search of the Medicare Nursing Home Compare website https://www.medicare.gov/nursinghomecompare/search.html resulted in 1 community nursing home in Lewistown, MT 59457 where the current CNH is located. The VA’s Vendor Information Page (VetBiz) was used to determine if potential offerors exist to provide additional competition. However, the site failed to produce any results for zip code 59457, NAICS 623110 Nursing Care Facilities.

Results of the market research show there is no other CNH that expressed interest.

Typically, CNH's are not competed. Based on the CNH program requirements, the veteran’s preference is taken into consideration when selecting a CNH based on the Veteran needs, proximity to home/residence and family. The CNH Program attempts to inspect a sample of CNH's in a given area to provide the Veteran with several choices. However, the selection of the CNH is determined on whether the CNH has the resources available to meet the Veteran’s needs. The CNH Program Coordinator is responsible for conducting market research and required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections.

9. Any Other Facts Supporting the Use of Other than Full and Open Competition:

The CNH is currently providing care for 3 Veterans in this facility who cannot be

OFOC SOP Revision 08 Page 4 of 5

Revision 08 Date: 04/18/2018 relocated due to continuity of care and medical complexity. This CNH is located near the families of the Veterans. We would cause undue stress to the Veteran and family if we tried to relocate the Veterans.

10. Listing of Sources that Expressed, in Writing, an Interest in the Acquisition:

No other CNH expressed interest in this acquisition. The current contractor, Empress at Lewistown, LLC dba Central Montana Nursing & Rehabilitation Center, has expressed an interest to continue providing CNH services to the VA and continue in providing care and services to the Veterans currently placed there.

11. A Statement of the Actions, if any, the Agency May Take to Remove or

Overcome any Barriers to Competition before Making subsequent acquisitions for the supplies or services required: There is currently only one (1) facility capable of providing the specialty care and medical needs of the existing Veterans.

Based on the CNH program requirements, the Veteran’s preference is taken into consideration when selecting a CNH based on the Veteran needs, proximity to home/residence and family. The CNH Program attempts to inspect a sample of CNH's in a given area to provide the Veterans with several choices. However, the selection of the CNH is determined on whether the CNH has the resources available to meet each Veteran's needs. The CNH Program Coordinator is responsible for conducting market research and required inspections to increase the number of available and qualified CNH's that can pass the Government's inspections. The contracting office and CNH Program office will continue to canvas the market for new CNH entrants capable of meeting program requirements.

12. Requirements Certification: I certify that the requirement outlined in this justification is a Bona Fide Need of the Department of Veterans Affairs and that the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Date

13. Approvals in accordance with the VHAPM Part 806.3 OFOC SOP:

a. Contracting Officer or Designee’s Certification (required): I certify that the foregoing justification is accurate and complete to the best of my knowledge and belief.

03/09/2020

3/13/2020

OFOC SOP Revision 08 Page 5 of 5

b. One Level Above the Contracting Officer (Required over SAT but not exceeding $700K): I certify the justification meets requirements for other than full and open competition.

c. NCO-19 Director of Contracting REVIEW AND APPROVAL (over $700,000 to $13.5 million): I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition.

d. VHA RPO HCA REVIEW AND APPROVAL (over $700,000 to $13.5 million):

I have reviewed the foregoing justification and find it to be complete and accurate to the best of my knowledge and belief and approve for other than full and open competition.

03/13/2020

03/24/2020

3/26/2020